86631
HCPCS Procedure Code
HCPCS code 86631 is the #4,805 most-billed Medicaid procedure code, with $393K in payments across 57K claims from 2018–2024. The national median cost per claim is $8.67.
Total Paid
$393K
0.00% of all spending
Total Claims
57K
Providers
70
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 86631? Based on 61 providers billing this code nationally.
Median
$8.67
Average
$10.13
Std Dev
$9.82
Max
$60.14
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.01 and $11.97 per claim for this code.
90% bill between $2.08 and $14.50.
Top 1% bill above $56.41.
About This Procedure
HCPCS code 86631 was billed by 70 providers across 57K claims, totaling $393K in Medicaid payments from 2018–2024. This code was used for 53K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.67
Providers Billing
61
National Spending
$393K
Avg/Median Ratio
1.17×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 86631
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1730209545 | $66K |
| 2 | Quest Diagnostics Incorporated Clifton, NJ · Clinical Medical Laboratory | $53K |
| 3 | 1205978616 | $51K |
| 4 | Bioreference Health Llc Elmwood Park, NJ · Clinical Medical Laboratory | $46K |
| 5 | Laboratory Corporation Of America Holdings Burlington, NC · Clinical Medical Laboratory | $26K |
| 6 | Laboratory Corporation Of America Holdings Raritan, NJ · Clinical Medical Laboratory | $18K |
| 7 | 1750589982 | $14K |
| 8 | Tricore Reference Laboratories Albuquerque, NM · Clinical Medical Laboratory | $13K |
| 9 | 1598741753 | $10K |
| 10 | Sunrise Medical Laboratories, Inc. Hicksville, NY · Clinical Medical Laboratory | $8K |
| 11 | Accurate Diagnostics Labs, Inc. South Plainfield, NJ · Clinical Medical Laboratory | $8K |
| 12 | Clinical Pathology Laboratories, Inc. Austin, TX · Clinical Medical Laboratory | $8K |
| 13 | 1578569885 | $7K |
| 14 | Accu Reference Medical Lab, Llc Linden, NJ · Clinical Medical Laboratory | $6K |
| 15 | Quest Diagnostics Clinical Laboratories Inc Miramar, FL · Clinical Medical Laboratory | $5K |
| 16 | 1437279676 | $4K |
| 17 | Labone Of Ohio Inc Cincinnati, OH · Clinical Medical Laboratory | $4K |
| 18 | Unilab Corporation West Hills, CA · Clinical Medical Laboratory | $4K |
| 19 | Quest Diagnostics Clinical Laboratories Inc Irving, TX · Clinical Medical Laboratory | $3K |
| 20 | 1194254219 | $3K |
Showing top 20 of 70 providers billing this code